Transcript
AFFIDAVIT OF REPOSSESSION (WYOMING) (WSS 31-2-104(c), 34.1-9-620 and 34.1-9-623)
State of ______________________________ ) ) ss County of _____________________________ ) I, _______________________________________________________, hereby swear (or affirm) that I am the duly appointed and acting ____________________________________________ of the _____________________________________________; that said corporation or company has a mailing address ____________________________________________________________________ and is the legal owner and did repossess from ____________________________________________, the registered owner, the motor vehicle described as follows: Make _________________________ Type ________________________ Year or Model ___________________ VIN________________________________________ Converse County Vehicle Title Number 13 ‐ _______________; that repossession was made under the following terms and conditions (explain fully the reason for repossession): ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ _________________________________________________________________________; that said vehicle was repossessed by said legal owner on or about the _______ day of ___________, _______, by (process of law) (peaceable means); that the registered owner (did) (did not) deliver the said certificate of title to the legal owner at the time of repossession; that this affidavit is made for the purpose of establishing ownership of said motor vehicle in order to obtain a new certificate of title; and that the Wyoming Secretary of State and County Clerks will be held harmless and the various officers will be indemnified against liability arising from such repossession; that the name and address to appear on the new vehicle title is ____________________________________________________________________________________. ____________________________________________________ Signature ____________________________________________________ Position and Business Name Subscribed and sworn before me this ______ day of __________________________, ________. Witness my hand and official seal. _________________________________________ (SEAL) County Clerk or Notary Public My commission expires: ______________________________
Complete BOTH PAGES of this form.
Note: The staff of the Converse County Clerk’s Office is not allowed to give legal advice. If you are in need of legal advice, please Z:\PUBLIC\Forms\Titles & Security Agrmts\Affidavit of Repossession.doc
Eff: 09.16.2011
contact a private attorney. ASSIGNMENT OF OWNERSHIP This is to be filled in by the seller and delivered to the county clerk. Purchaser must make application for a new certificate of title with the county clerk. PURCHASER(S) NAME_______ _________________________________________________________________________ (must be printed) PURCHASER(S) ADDRESS _____________________________________________________________________________ Street City State Zip
ODOMETER DISCLOSURE STATEMENT FEDERAL AND STATE REGULATIONS REQUIRE you to state the mileage upon transfer of ownership of a motor vehicle. Failure to complete or providing a false statement may result in fines and/or imprisonment. I, __________________________________________________________, hereby state that the odometer now reads _________________ (no tenths) miles and to the best of my knowledge, it reflects the statement checked below: ___ the actual mileage of the vehicle, or ___ the amount of mileage in excess of mechanical limits; or ___ the odometer reading is NOT the actual mileage - WARNING, ODOMETER DISCREPANCY.
WARRANT AND NOTARIZATION I/we do hereby certify and warrant that I/we am/are the true and lawful owner(s) of the vehicle described herein and further warrant that the liens and encumbrances noted hereon are the only liens and encumbrances against the vehicle herein described and hereby transfer and convey all rights, title and interest that I/we have in the vehicle herein described to the above named individual(s); and if the vehicle herein described is a mobile home, do hereby certify that all taxes due for the preceding and current year on the mobile home have been paid. ALL OWNERS WHOSE NAME APPEARS ON THE TITLE FACE OR THE REPOSSESSION AGENT MUST SIGN IN THE PRESENCE OF A NOTARY PUBLIC SIGNATURE OF SELLER(S) __________________________________________________________________ SIGNATURE OF SELLER(S) __________________________________________________________________ PRINT NAME OF SELLER(S) __________________________________________________________________ PRINT ADDRESS OF SELLER(S) ______________________________________________________________ DATE OF SALE _____________________________________________________________________________ SELLER(S) NOTARY STATEMENT Subscribed and sworn to (or affirmed) before me by __________________________________________________ in the State of ___________________, County of _____________________________ this __________ day of __________________, _________. County Clerk or Notary Public Signature __________________________________________________________ My Commission Expires ________________________ (SEAL)
Complete BOTH PAGES of this form.
Note: The staff of the Converse County Clerk’s Office is not allowed to give legal advice. If you are in need of legal advice, please Z:\PUBLIC\Forms\Titles & Security Agrmts\Affidavit of Repossession.doc Eff: 09.16.2011
contact a private attorney.
Z:\PUBLIC\Forms\Titles & Security Agrmts\Affidavit of Repossession.doc
Eff: 09.16.2011
